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An open-Label, 2 × 2 factorial, randomized controlled trial to evaluate the safety of apixaban vs. vitamin K antagonist and aspirin vs. placebo in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention: Rationale and design of the AUGUSTUS trial Current Smoking and Prognosis After Acute ST-Segment Elevation Myocardial Infarction: New Pathophysiological Insights Global Chronic Total Occlusion Crossing Algorithm: JACC State-of-the-Art Review Select Drug-Drug Interactions With Direct Oral Anticoagulants Multivessel Versus Culprit-Vessel Percutaneous Coronary Intervention in Cardiogenic Shock Effect of a Home-Based Wearable Continuous ECG Monitoring Patch on Detection of Undiagnosed Atrial Fibrillation The mSToPS Randomized Clinical Trial Biolimus-A9 polymer-free coated stent in high bleeding risk patients with acute coronary syndrome: a Leaders Free ACS sub-study Mode of Death in Heart Failure With Preserved Ejection Fraction Generalizing Intensive Blood Pressure Treatment to Adults With Diabetes Mellitus Burden of 30-Day Readmissions After Percutaneous Coronary Intervention in 833,344 Patients in the United States: Predictors, Causes, and Cost

Review ArticleVolume 72, Issue 23 Part A, December 2018

JOURNAL:J Am Coll Cardiol. Article Link

ACC/AHA Versus ESC Guidelines on Dual Antiplatelet Therapy JACC Guideline Comparison: JACC State-of-the-Art Review

D Capodanno, F Alfonso, GN Levine et al. Keywords: antiplatelet; bleeding; stent; thrombosis; ACC/AHA Versus ESC Guidelines

ABSTRACT


Dual antiplatelet therapy (DAPT) is the cornerstone of pharmacological treatment aimed at preventing the atherothrombotic complications in patients with a variety of coronary artery disease (CAD) manifestations. Prescribers of DAPT are confronted with a number of challenges that include selecting the appropriate P2Y12 inhibitor and determining the optimal duration of DAPT with the scope of minimizing the risk of ischemic and bleeding complications in light of each patient’s clinical characteristic and circumstance. Recently, a guideline writing committee from the American College of Cardiology/American Heart Association (ACC/AHA) and a task force from the European Society of Cardiology (ESC) released their respective focused update recommendations on “Duration of DAPT in Patients with CAD” (ACC/AHA) and “DAPT in CAD” (ESC). This paper aims to review the ACC/AHA and ESC updates for DAPT to delineate common domains, consistent messages, and differences in recommended management strategies across the Atlantic.